If your child has cerebral palsy, there's a monitoring schedule for their hips that you may not have heard about yet. It's called hip surveillance, and it's designed to catch displacement early, before it becomes painful or requires major surgery. Many families don't learn about this pathway until their child is already experiencing discomfort or an orthopedist flags a problem on an X-ray. But the monitoring protocol exists for a reason: children with CP are at higher risk for hip displacement as they grow, and catching it early makes a significant difference in outcomes. Here's what hip surveillance is, why it matters, and what the recommended schedule looks like based on your child's GMFCS level. What Hip Surveillance Is. Hip surveillance is a proactive monitoring program using scheduled X-rays to track how well the hip joint is staying in place as your child grows. It's not treatment. It's early detection. The X-rays measure something called the migration percentage, which shows how much of the femoral head (the ball of the hip joint) is sitting outside the socket. A migration percentage under 30% is generally considered stable. Above that, orthopedists start watching more closely or discussing intervention. Without monitoring, hip displacement can progress silently. By the time a child is in pain or has visible gait changes, the hip may have migrated significantly, narrowing the window for less invasive options like physical therapy adjustments, bracing, or muscle release surgery. Why Children with CP Are at Higher Risk. Cerebral palsy affects muscle...

Proactive hip X-ray monitoring prevents painful dislocation in children with CP. Here's the schedule by GMFCS level.

Hip Surveillance for Children with Cerebral Palsy: A Parent's Guide to the Monitoring Schedule

If your child has cerebral palsy, there's a monitoring schedule for their hips that you may not have heard about yet. It's called hip surveillance, and it's designed to catch displacement early, before it becomes painful or requires major surgery. Many families don't learn about this pathway until their child is already experiencing discomfort or an orthopedist flags a problem on an X-ray. But the monitoring protocol exists for a reason: children with CP are at higher risk for hip displacement as they grow, and catching it early makes a significant difference in outcomes. Here's what hip surveillance is, why it matters, and what the recommended schedule looks like based on your child's GMFCS level. What Hip Surveillance Is. Hip surveillance is a proactive monitoring program using scheduled X-rays to track how well the hip joint is staying in place as your child grows. It's not treatment. It's early detection. The X-rays measure something called the migration percentage, which shows how much of the femoral head (the ball of the hip joint) is sitting outside the socket. A migration percentage under 30% is generally considered stable. Above that, orthopedists start watching more closely or discussing intervention. Without monitoring, hip displacement can progress silently. By the time a child is in pain or has visible gait changes, the hip may have migrated significantly, narrowing the window for less invasive options like physical therapy adjustments, bracing, or muscle release surgery. Why Children with CP Are at Higher Risk. Cerebral palsy affects muscle...

Proactive hip X-ray monitoring prevents painful dislocation in children with CP. Here's the schedule by GMFCS level.

Hip Surveillance for Children with Cerebral Palsy: A Parent's Guide to the Monitoring Schedule

Your child's orthopedist says they'll keep monitoring the hips. You hear that at every appointment. What you don't always hear is what they're watching for, or what number on an x-ray report turns "monitoring" into "we need to schedule surgery." Hip displacement is progressive in cerebral palsy. It doesn't announce itself with pain in the early stages. By the time a child is uncomfortable, the femoral head has already migrated out of the socket far enough that surgical options narrow. That's why surveillance exists: a schedule of x-rays tied to your child's GMFCS level, designed to catch displacement before it becomes a crisis. This is the framework your orthopedist is using. Here's what the numbers mean and when intervention moves from optional to necessary. Why Hips Displace in CP. Muscle imbalance pulls the femoral head out of position over time. In spastic cerebral palsy, tight hip flexors and adductors create constant inward and upward force on the thigh bone. The hip socket (the acetabulum) doesn't develop properly when the femoral head isn't seated correctly, which keeps the socket shallow and allows the head to migrate further in a self-reinforcing cycle. Kids who don't walk bear less weight through their hips, which means less stimulus for the socket to deepen. GMFCS levels IV and V carry the highest risk: up to 90% will develop some degree of hip displacement without surveillance. GMFCS III is lower but still significant. GMFCS I and II have near-zero risk of progressive displacement. The good news:...

Hip x-ray schedules, migration percentages, and clinical decision points that separate monitoring from surgical intervention.

Hip Surveillance in Cerebral Palsy: When Monitoring Becomes Surgery

Your child's orthopedist says they'll keep monitoring the hips. You hear that at every appointment. What you don't always hear is what they're watching for, or what number on an x-ray report turns "monitoring" into "we need to schedule surgery." Hip displacement is progressive in cerebral palsy. It doesn't announce itself with pain in the early stages. By the time a child is uncomfortable, the femoral head has already migrated out of the socket far enough that surgical options narrow. That's why surveillance exists: a schedule of x-rays tied to your child's GMFCS level, designed to catch displacement before it becomes a crisis. This is the framework your orthopedist is using. Here's what the numbers mean and when intervention moves from optional to necessary. Why Hips Displace in CP. Muscle imbalance pulls the femoral head out of position over time. In spastic cerebral palsy, tight hip flexors and adductors create constant inward and upward force on the thigh bone. The hip socket (the acetabulum) doesn't develop properly when the femoral head isn't seated correctly, which keeps the socket shallow and allows the head to migrate further in a self-reinforcing cycle. Kids who don't walk bear less weight through their hips, which means less stimulus for the socket to deepen. GMFCS levels IV and V carry the highest risk: up to 90% will develop some degree of hip displacement without surveillance. GMFCS III is lower but still significant. GMFCS I and II have near-zero risk of progressive displacement. The good news:...

Hip x-ray schedules, migration percentages, and clinical decision points that separate monitoring from surgical intervention.

Hip Surveillance in Cerebral Palsy: When Monitoring Becomes Surgery

You leave the physical therapy appointment with a referral for something called a gait trainer. The prescription lists a model, a HCPCS code, and a dollar amount that makes you look twice. You already have a standard walker at home that cost less than a pair of sneakers. The question sitting in the car with you on the way home is: why? That question has a real answer, and it starts with understanding what the two devices do differently. What a Gait Trainer Does. A standard walker gives your child something to hold and lean on. That's genuinely useful for a child who has the balance and trunk control to upright themselves, the hip stability to shift weight from foot to foot, and the coordination to advance the walker in a controlled rhythm. A gait trainer does something the standard walker cannot. It supports your child's body weight from above or behind, so your child doesn't have to recruit every postural muscle just to stay upright before their feet have done anything. The pelvic harness or trunk support holds your child in alignment during each step. It guides the reciprocal pattern of walking, left foot, right foot, left foot, in a way that repetition builds into neuromuscular memory. Here's what the physical therapist is seeing when they look at your child in a standard walker: a child spending so much effort just maintaining upright position that there's nothing left for the actual work of stepping. The gait trainer removes that...

Gait Trainers for Children: When Walkers Aren't Enough

You leave the physical therapy appointment with a referral for something called a gait trainer. The prescription lists a model, a HCPCS code, and a dollar amount that makes you look twice. You already have a standard walker at home that cost less than a pair of sneakers. The question sitting in the car with you on the way home is: why? That question has a real answer, and it starts with understanding what the two devices do differently. What a Gait Trainer Does. A standard walker gives your child something to hold and lean on. That's genuinely useful for a child who has the balance and trunk control to upright themselves, the hip stability to shift weight from foot to foot, and the coordination to advance the walker in a controlled rhythm. A gait trainer does something the standard walker cannot. It supports your child's body weight from above or behind, so your child doesn't have to recruit every postural muscle just to stay upright before their feet have done anything. The pelvic harness or trunk support holds your child in alignment during each step. It guides the reciprocal pattern of walking, left foot, right foot, left foot, in a way that repetition builds into neuromuscular memory. Here's what the physical therapist is seeing when they look at your child in a standard walker: a child spending so much effort just maintaining upright position that there's nothing left for the actual work of stepping. The gait trainer removes that...

Push Girls, a reality show set to debut in April on the Sundance Channel, follows the lives of four women who have been paralyzed by either disease or tragic accidents. While each of these women use wheelchairs in everyday life, the title of the show refers to pushing through obstacles such as stereotypes and career challenges. Producer Gay Rosenthal previously worked on Little People, Big World, a series about a couple with dwarfism raising a typically sized family, and Ruby, a show about a morbidly obese woman's journey to lose weight. Push Girls follows in the same vein of tackling life “with spirit and confidence,” as Rosenthal says. “The show challenges perceptions about life in a wheel chair, giving the audience an honest, non-nonsense look into [these women's] world,” she tells C21 Media. Each of these women portrayed on the show had to face leaving a dream from their youth behind due to their disabilities. One was once a swim star and another a hip hop dancer, but as life goes on, all of these women are embracing new dreams, including motherhood, relationships, athletics and even stardom. Tiphany Adams is one star of the show. She is the lone survivor of a car accident that took the lives of three friends while she was in high school. “Most people would want to give up,” she tells the New York Post, “But all four of us girls chose triumph over tragedy.” Read more here.

'Push Girls' reality show on Sundance Channel features four paralyzed women confronting stereotypes and pursuing new dreams.

New Reality Show Follows Life with Disability

 Push Girls, a reality show set to debut in April on the Sundance Channel, follows the lives of four women who have been paralyzed by either disease or tragic accidents. While each of these women use wheelchairs in everyday life, the title of the show refers to pushing through obstacles such as stereotypes and career challenges.  Producer Gay Rosenthal previously worked on Little People, Big World, a series about a couple with dwarfism raising a typically sized family, and Ruby, a show about a morbidly obese woman's journey to lose weight. Push Girls follows in the same vein of tackling life “with spirit and confidence,” as Rosenthal says. “The show challenges perceptions about life in a wheel chair, giving the audience an honest, non-nonsense look into [these women's] world,” she tells C21 Media. Each of these women portrayed on the show had to face leaving a dream from their youth behind due to their disabilities. One was once a swim star and another a hip hop dancer, but as life goes on, all of these women are embracing new dreams, including motherhood, relationships, athletics and even stardom. Tiphany Adams is one star of the show. She is the lone survivor of a car accident that took the lives of three friends while she was in high school. “Most people would want to give up,” she tells the New York Post, “But all four of us girls chose triumph over tragedy.” Read more here.


Couples who plan to adopt often look to other countries with cultures similar to their own. That is why Megan and Keith Nakamoto began the China adoption process in 2005. "My husband is Japanese, so we are familiar with the Asian culture. We thought it would be a smoother culture for [adopted daughter Tessa]," Megan Nakamoto tells the Chicago Tribune. While most U.S. adoption agencies have stopped accepting applications for China's traditional program due to a lengthy wait time (up to six years), programs like Waiting Child release children with minor to significant special needs in as little as a year. Couples like the Nakamotos who are perhaps older and do not want the age gap between their other children to grow too large are opting for programs like Waiting Child more and more. The Nakamotos prepared for a special needs adoption by assessing their health insurance and finances to ensure that they could provide the proper care for a child with health issues. A year after submitting their application to Waiting Child, they were on a flight to China to bring Tessa home. Now Tessa has undergone surgery to repair her cleft palate and ear tubes, and she sees a physical therapist to work on her leg and hip, which are turned out for unknown reasons. Another woman, Kara Bourke, who was on a waiting list for China's traditional adoption program for over a year, considered adopting a child with special needs when she realized she wasn't making...

Couples are choosing special needs adoption to avoid long waits, such as Nakamotos and Bourke who adopted from China.

More Couples Look to Special Needs Adoption

Couples who plan to adopt often look to other countries with cultures similar to their own. That is why Megan and Keith Nakamoto began the China adoption process in 2005. "My husband is Japanese, so we are familiar with the Asian culture. We thought it would be a smoother culture for [adopted daughter Tessa]," Megan Nakamoto tells the Chicago Tribune. While most U.S. adoption agencies have stopped accepting applications for China's traditional program due to a lengthy wait time (up to six years), programs like Waiting Child release children with minor to significant special needs in as little as a year. Couples like the Nakamotos who are perhaps older and do not want the age gap between their other children to grow too large are opting for programs like Waiting Child more and more. The Nakamotos prepared for a special needs adoption by assessing their health insurance and finances to ensure that they could provide the proper care for a child with health issues. A year after submitting their application to Waiting Child, they were on a flight to China to bring Tessa home. Now Tessa has undergone surgery to repair her cleft palate and ear tubes, and she sees a physical therapist to work on her leg and hip, which are turned out for unknown reasons.  Another woman, Kara Bourke, who was on a waiting list for China's traditional adoption program for over a year, considered adopting a child with special needs when she realized she wasn't making...

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Special Needs
Articles

Hip Surveillance for Children with Cerebral Palsy: A Parent's Guide to the Monitoring Schedule

Hip Surveillance in Cerebral Palsy: When Monitoring Becomes Surgery

Gait Trainers for Children: When Walkers Aren't Enough

New Reality Show Follows Life with Disability

More Couples Look to Special Needs Adoption

Find Providers Near You

Special Needs Articles

Hip Surveillance for Children with Cerebral Palsy: A Parent's Guide to the Monitoring Schedule

Hip Surveillance in Cerebral Palsy: When Monitoring Becomes Surgery

Gait Trainers for Children: When Walkers Aren't Enough

New Reality Show Follows Life with Disability

More Couples Look to Special Needs Adoption

Find Providers Near You

Special Needs
Articles